Tummy Tuck Surgery
For many patients in Los Angeles, a tummy tuck, or abdominoplasty is an excellent option to remove the pudge below the belly button, particularly after pregnancy when the muscles separate. This procedure is often combined with liposuction to create a more sculpted result. The unwanted fat from liposuction can be used to plump up the buttock with fat grafting, known as a Brazilian butt lift. The removed fat can also be placed into the face to restore a youthful facial profile. This is called fat grafting. More about this procedure can be found here.
Abdominoplasty can dramatically reduce the appearance of a protruding abdomen. The results are immediate and dramatic.
Smoking habits, age and obesity are some of the factors the physician considers when evaluating a candidate for this procedure. Smokers should be off all cigarettes or nicotine patches for at least 4 weeks before surgery. Why? Smoking constricts blood vessels and compromises wound healing. If you smoke and have a tummy tuck there is a good chance your incisions will open up. Nicotine patches and Nicorette gum are not solutions because it is the nicotine in smoking that constricts small blood vessels.
Who is a Good Candidate?
The best candidates for abdominoplasty are men and women who are in relatively good physical shape but are bothered by a fat deposit or loose abdominal skin that has not responded to diet or exercise. Some women also find pregnancy stretches the muscles of the abdominal wall (called diastasis) and all the dieting and exercising in the world won’t help return the belly to its pre-pregnancy state. The muscles need to be surgically tightened through abdominoplasty to achieve the most natural, long-lasting results. In other cases, loss of skin elasticity, caused by age or weight fluctuation, can also be improved with this procedure.
People who intend to lose a lot of weight should postpone the surgery. Best results are in men and women who have had a stable weight for at least six months. It makes little sense to undergo a big operation only to lose more weight following surgery. Weight loss, particularly rapid weight loss, can cause skin laxity. In addition, even after the excess bulge is removed, one can still gain weight after surgery. Fortunately, most people find the body transformation from an abdominoplasty encourages them to exercise more to maintain their positive results.
Rapid Weight Loss
Sometimes the skin doesn’t catch up to the weight loss. As we age, our skin loses elasticity, making our body more like a beach ball than a balloon. With poor skin tone, sometimes the only solution is skin resection. For men and women who lose a substantial amount of weight fast, such as after gastric bypass or lap-band surgery, the skin issue is generally not isolated to the belly. Tummy tucks in this population could and should be combined with other skin resection procedures such as a body lift or mastopexy (breast lift).
What is the downtime for abdominoplasty?
Since the muscles are tightened and need to heal after a tummy tuck, you should avoid strenuous activity for 2 weeks. You should also refrain from activity that requires use of your nabdominal muscles for four weeks. People are generally sore for up to three days after a tummy tuck and may walk hunched over. But for the most part, pain is well controlled with oral medications. Abdominoplasty is almost always an outpatient procedure, meaning patients will go home the same day. However, if one prefers to stay overnight in a facility with a nurse, that can be arranged through the office.
When the fat deposits are limited to the area below the belly button, you may require a smaller procedure called a partial abdominoplasty, also known as a mini-tummy tuck. A mini-tuck is nearly always performed on an outpatient basis.
When you meet with Dr. Neavin, a complete medical history will be obtained that includes a full medication list. Because abdominoplasty takes three to four hours to complete, it is important that you are in relatively good shape to ensure a safe procedure. Any ongoing medical conditions may have to be discussed with your primary care doctor for clearance. Skin quality, as well as fat deposition, will be examined. Loose skin alone does not make one a good candidate for this procedure. Sometimes, as in the case with massive weight loss patients, loose skin is circumferential (around the entire body), and thus addressing only the abdomen may create a patch-work like result. For some people that is satisfactory, but body lifting with skin excision in the love handles and lower back may yield a more powerful result.
If you have weakened abdominal muscles or separation of the muscles (diastasis), then muscle tightening will be offered. Many times when men and women simulate how they would like their abdomen to look, they “suck it in”. Essentially, the tightening of the rectus abdominus muscles can have a very similar effect.
If skin elasticity is relatively good, then liposuction of the love handles will often be suggested to create a more hour glass shape in women and a more stream line shape in men.
Dr. Neavin will also examine you for a hernia. Hernias can exist in many areas of the body, but as it relates to abdominoplasty, hernias of the abdomen (ventral) or belly button (umbilicus) may need to be repaired during the procedure.
Types of Tummy Tucks
There are several different types of abdominoplasties. They differ in the components they address and the complexity of the surgery. In simple terms, there are:
Standard abdominoplasty: Excess skin is excised and the muscles are tightened. Liposuction is performed of the waist and often, the lower back. The belly button is recreated.
Mini Tuck: Only skin is excised. The belly button is not recreated. Muscles are not tightened.
Extended: The incision is carried more laterally to the flank. This is a frequent necessity for men and women who have lost significant weight. In fact, the incision often is carried to the back side. This is called a body lift. Muscles are tightened and the belly button is recreated.
Fleur de Lis: This abdominoplasty addresses laxity in both vertical and horizontal vectors. Skin is remove in the shape of an upside down V from the sternum to pubis. The resultant incision looks like an inverted T. The fleur de lis abdominoplasty is reserved for men and women with significant skin excess. Many patients who lose massive weight will benefit from this surgery Muscles are often tightened and the belly button is recreated.
Floating: A floating tummy tuck refers to the fact that the belly button is not recreated. In patients with reasonably good skin but loose muscles, one option is to tighten the muscles with resection much (if any) skin. In these cases, the belly button may be relocated a little lower on the abdomen but there is no need to recreate it and add the additional scar.
What are the scars associated with abdominoplasty?
The aim of scar placement is to hide them inside the lines of common swimwear. Generally, the incisions are placed low enough to be concealed even in underwear. If there is a large resection of skin, there will need to be an incision (and scar) around the belly button. There are several techniques that plastic surgeons utilize to reduce scar exposure of the belly button. Dr. Neavin takes great pride in this particular part of the operation and has his own technique to minimize scar visibility and create an attractive, slight depression to accentuate the center of the abdomen. All scars go through phases and begin to fade within months after your procedure. Darker-skinned individuals may have more visible scarring than people with fairer skin. Dr. Neavin will discuss with you his thoughts on scarring based on the current condition of your skin and your scar history.
A tummy tuck is a surgical procedure that yields dramatic body contouring results. Schedule your consultation with Dr. Neavin today at 310‑858‑8811 or text 323‑975‑1287 and find out if a tummy tuck is a good option for you.